What Are Epidural Steroid Injections?

The epidural steroid injections are long lasting steroid (CORTISONE) injections that are injected into the Epidural space, the area which surrounds the spinal cord and the nerves coming out of it, to relieve the severe back pains, inflammation and/or swelling of nerves in the Epidural space, and to reduce pain, tingling & numbness and other symptoms caused by nerve inflammation / irritation or swelling. The epidural steroid injections are sometimes also called spinal injections. 


The epidural steroid injections were first used in 1952 to cure low back pain associated with sciatica (pain in the sciatic nerve due to lumbar disc herniation). The epidural steroid injections are popular non-surgical treatment for low back pain. The epidural steroid injections are mixture of local anesthetics, such as lidocaine or bupivacaine and the steroid medications triamcinolone – Aristocort® or methylprednisolone – Depo-medrol®, Celestone-Soluspan. 
The epidural steroid injections are effective non-surgical treatment for the patients suffering from severe acute or chronic low back pain and/or leg pain caused by the conditions, such as lumbar disc herniation, degenerative disc disease, and lumbar spinal stenosis. 

The epidural steroid injections are administered making patient lie flat on x-ray table on their abdomen. Before giving epidural steroid injections, skin is numbed with lidocaine that is similar to the novocaine (anesthetic) that the dentists use. The patients may feel their legs slightly heavy and may be numb after epidural steroid injections, and they are monitored for 15 to 20 minutes with EKGs, blood pressure cuffs and blood oxygen monitoring devices.


The immediate effects of epidural steroid injections disappear in a few hours. The epidural steroid injections (cortisone) start working in about 3 to 5 days, and their effect lasts for several days to a few months. If the first injections do not relieve of pain in about a week to two weeks, the patients may be recommended to go for epidural steroid injections again. If the second injections also do fail to work, the patients may be recommended to go for the third round of epidural steroid injections, but patients can't be given more than 3 epidural steroid injections in a period of six months.

However, epidural steroid injections are linked with some risks, side effects, and possibility of complications, which include risk of spinal puncture with headaches, infection, bleeding inside the Epidural space with nerve damage, worsening of symptoms etc. The side effects of CORTISONE may include weight gain, increase in blood sugar (mainly in diabetics), water retention, suppression of body's own natural production of cortisone etc.